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Scholarship Form

The scholarship application form that follows is a very thorough form, requiring detailed information. Please understand that this particularization is not for the sake of complicating your request, but on the contrary, it is intended to ultimately work to your advantage, as it will enable the committee to screen applications upon the basis of genuine need. It is therefore most important that you thoroughly complete each section of the form. If you require any assistance in completing your application, please feel free to call 412-867-9266.

Please note, all sections must be filled out. If it does not apply to you, write n/a. 

* All information provided on the scholarship applications will be kept in strictest confidence

 

   4: Agreement
 1: Basic Information
 1a) Name(s) of child(ren) applying for scholarships

 Name: Gender:    Age:

Date of Birth:   

 Name: Gender:      Age:

Date of Birth:   

 Name: Gender:      Age:

Date of Birth:   

 Name: Gender:      Age:

Date of Birth:    

 1b) Contact Info.

 Address 

City   State     Zip  

Phone numbers:

         

 House                    Cell phone                Work

 Email 

 1c) Income Information

Current Year's Total Family Income,
including second jobs, alimony, 
child support etc.:                             

Last Year's Total Family Income,
including second jobs, alimony,
child support etc.:                          

 

2) School Tuition Costs

 How many children do you have? 

Please list each child's name, school and tuition costs:

 

 3: References

 List two non-related references who would be familiar with your situation (optional):

Name                                Address                        Phone number

         

         

How many weeks will your child/ren be attending camp? 

What will your child/ren do for the rest of the summer? 

Are you paying tuition fees to any other camps this summer? 

If yes, please list the camps and their fees:

 

Please state clearly the reason(s) why you feel a scholarship should be granted in your situation.

 

Is there something you or someone in your family can offer to enhance our camp? A talent to share? Some time to volunteer?

 

How much do you feel you can afford to pay for camp? (per week) 

I hereby certify that all of the above information is correct and answered to the best of my ability.

I understand that my application is not complete until I submit my most recent tax return to admin@cgipittsburgh.com. 


Applicant Name:
Initial: 
 

Date: 
 

 

 

 

 

 

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Camp Gan Israel 2100 Wightman Street Pittsburgh, PA 15217 412-657-8164
A branch of the world's largest Jewish Camping network, Camp Gan Israel International

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